Cockroaches are worse than pets and dust mites for people with asthma, a study says.
Researchers found cockroach allergens played a "very important role" in exacerbating the symptoms of asthma in inner city children in the US.
The University of Texas Southwestern Medical Center studied 937 children.
It found children missed more school days and visited the doctor more with asthma symptoms brought on by cockroach allergens than others.
Reaction to pet allergens also had an impact but it was found to be borderline, while dust mite exposure did not exacerbate symptoms, the Journal of Allergy and Clinical Immunology reported.
Report author Rebecca Gruchalla said the allergic reaction to cockroaches varied from child to child but skin testing showed that 69% were sensitive.
Children
But she added cockroaches played a "very important role in exacerbating asthma symptoms in inner city children who are sensitive and exposed to high levels of that allergen".
She said parents can protect their children by making sure homes are clean
"To minimise exposure to cockroach allergens, eat only in the kitchen and dining room, keep shelf food in plastic containers or sealable bags, take the garbage out daily and clear counter tops and floors regularly."
Children aged five to 11 with moderate or severe asthma in inner city areas such as Bronx, Boston, Chicago, Dallas, New York City and Seattle underwent allergen skin testing during the study.
More than 5m people in the UK have asthma with one in five households affected.
But the charity Asthma UK said it was widely accepted that cockroaches exacerbated asthma symptoms.
She also said cockroaches were not as common in the UK as other areas of the world so it was not such a problem.
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